Provider Demographics
NPI:1568564201
Name:SCHOW, BLAKE (DDS)
Entity Type:Individual
Prefix:DR
First Name:BLAKE
Middle Name:
Last Name:SCHOW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 S HIGLEY RD STE 117
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-4789
Mailing Address - Country:US
Mailing Address - Phone:480-632-7500
Mailing Address - Fax:623-247-0444
Practice Address - Street 1:1355 S HIGLEY RD STE 117
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-4789
Practice Address - Country:US
Practice Address - Phone:480-632-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6265122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ914433OtherAHCCCS